Prognostic Value of Obesity on Both Overall Mortality and Cardiovascular Disease in the General Population

BACKGROUND: Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event) in a general population sample from the south-east of Spain. MATERIALS AND METHODS: This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI) ≥30 kg/m(2)] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model. RESULTS: The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80–113) and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124–163). A BMI ≥35 kg/m(2) yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11–3.42) in comparison to non-obese subjects (BMI <30 kg/m(2)). For the combination of cardiovascular morbidity plus all-cause mortality, a BMI ≥35 kg/m(2) had a hazard ratio of 1.84 (95% CI: 1.15–2.93) compared to non-obese subjects. CONCLUSIONS: A BMI ≥35 kg/m(2) is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality.